| NPI | 1962692871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO MSPA.0000013) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005080) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2024-12-20 |